Member Incentive Programs Sample Clauses

Member Incentive Programs. Contractor may establish Member incentive programs to encourage appropriate utilization of health services and healthy behaviors. Member incentives may be financial or non-financial. Contractor will determine its own methodology for providing incentives to Members. Contractor must obtain DVHA approval prior to implementing its member incentive program and before making any changes thereto.
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Member Incentive Programs. Contractors shall establish member incentive programs to encourage appropriate utilization of health services and healthy behaviors. Member incentives may be financial or non- financial. The Contractor will determine its own methodology for providing incentives to members. For example, the Contractor may offer member incentives for:  Attending all prenatal visits;  Obtaining recommended preventive care;  Completing the expected number of EPSDT visits;  Complying with treatment in a disease management, care management or complex case management program;  Making healthy lifestyle decisions such as quitting smoking or losing weight; or  Completing a health screening. Except as provided herein, the Contractor may not offer gifts or incentives greater than $10.00 for each incentive and not to exceed $50.00 total per year per individual. The Contractor may petition OMPP, in the manner prescribed by OMPP, for authorization to offer items or incentives greater than $10.00 for each individual and $50.00 per year per individual if the items are intended to promote the delivery of certain preventive care services, as defined in 42 CFR 1003.101, Such incentives may not be disproportionate to the value of the preventive care service provided, as determined by OMPP. Petitions to provide enhanced incentives for preventive care shall be reviewed on a case-by-case basis, and OMPP shall retain full discretion in determining whether the enhanced incentives will be approved. In any member incentive program, the incentives shall be tied to appropriate utilization of health services and/or health-promoting behavior. For example, the member incentive programs can encourage responsible emergency room use or preventive care utilization. Contractors should develop member incentives designed to encourage appropriate utilization of health care services, increase adherence to keeping medical appointments and encourage the receipt of health care services in the appropriate treatment setting. Additionally, the Contractor shall comply with those requirements found in 42 CFR 1003.101, “Remuneration…(4) Incentives given to individuals to promote the delivery of preventive care services where the delivery of such services is not tied (directly or indirectly) to the provision of other services reimbursed in whole or in part by Medicare or an applicable State health care program. Such incentives may include the provision of preventive care, but may not include— (i) Cash or instruments c...
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Related to Member Incentive Programs

  • Incentive Programs During the Term of Employment, the ------------------ Executive shall be entitled to participate in any annual and long-term incentive programs adopted by the Company and which cover employees in positions comparable to that of the Executive.

  • Incentive Program Members who are rated as either Level I, Level II or Level III in every phase of the Physical Fitness Test are eligible to participate in the Incentive Program.

  • Long-Term Incentive Program During the Term, the Employee shall participate in all long-term incentive plans and programs of the Group that are applicable to its senior executives in accordance with their terms and in a manner consistent with his position with the Company.

  • Physician Incentive Plans In the event Provider participates in a physician incentive plan (“PIP”) under the Agreement, Provider agrees that such PIPs must comply with 42 CFR 417.479, 42 CFR 438.3, 42 CFR 422.208, and 42 CFR 422.210, as may be amended from time to time. Neither United nor Provider may make a specific payment directly or indirectly under a PIP to a physician or physician group as an inducement to reduce or limit Medically Necessary services furnished to an individual Covered Person. PIPs must not contain provisions that provide incentives, monetary or otherwise, for the withholding of services that meet the definition of Medical Necessity.

  • Bonus Programs Employee may participate in any incentive program which may be made available from time to time to Corporation’s employees at Employee’s level; provided, however, that Employee’s participation is subject to the applicable terms, conditions and eligibility requirements of the program, as they may exist from time to time.